In our current medical system, patients seeking treatment for a diagnosed medical condition may undergo treatments that are inferior to the best possible and available treatment methods. Although these treatments are often based on guidelines developed by various medical societies, significant variations in the actual treatment of a patient may be observed due to lack of treatment specificity in the guidelines, variations in the interpretations of the guidelines, or lack of familiarity with the most current guidelines, among other things. Because guidelines are generally treated as a framework within which doctors are encouraged to operate and not as requirements, healthcare providers are often given significant freedom in administering treatments. While those treatments will typically fall within the broad parameters of the guidelines, the administered treatments may not be optimal or most up-to date. These variations in treatments provided by different healthcare providers often lead to significant differences in the treatment results as well as medical costs associated with the treatment or management of the diseases. This may especially be the case, when healthcare providers may use non-working, discontinued, discredited, and/or last resort therapies that result in, for example, unnecessary hospitalizations, ventilator dependencies or ICU stays.
Furthermore, a lack of standardized and/or optimized and updated treatment methods often result in a complex billing process and significant billing overhead as the collection of payments for rendered services often involves a multitude of steps. In particular, a patient undergoing a treatment under the current system may be presented with confusing forms prior to and following the treatment to ensure that healthcare providers receive appropriate compensation for the services that they rendered. For example, the patient may be initially required to sign an agreement of patient's responsibility for the payments not covered by their insurance. Following a visit at the physician's office, the patient may receive a billing statement from the office, detailing claims submitted to the insurance company. Another statement from the insurance company may subsequently provide information as to some portion of the bill that was not covered by insurance, which may be followed by another communication from the physician's office for an additional payment for the uncovered portion of the bill. Also, the patient may be faced with other bills from laboratories, hospitals and/or clinics for services provided at these various facilities.
Thus, there is a need for a system that helps ensure that patients receive up-to-date treatment for their identified medical conditions in a more structured fashion. Also, there is a need for a system that provides patients with a more realistic assessment of the treatment outcome and is capable of suggesting alternative effective treatment methods that may potentially lead to savings in treatment costs for both patients and payors. Furthermore, there is a need for a system that reduces disease management costs by simplifying the billing process and reducing the overhead billing costs.